Gender Disparities in Medicine

Educational Objectives

The goal of this program is to facilitate the improvement of gender disparities in medicine. After hearing and assimilating this program, the clinician will be better able to:

1. Review the various types of sexual harassment against women commonly seen in health care.
2. Recommend strategies for women in the medical field to obtain an income equivalent to that of men.

Summary

Sexual harassment (SH): not just limited to unwanted sexual attention, eg, unwanted verbal or physical advances, sexual coercion, and favorable professional or educational treatment; gender harassment involves the use of obscene language and sexist hostility and is the most common form of SH; US Equal Opportunity Employment Commission states that the most common industries with SH of women are hospitality, health care (HC), manufacturing, and social services; female students in medicine report SH more frequently than those in science and engineering; 30% of women on medical faculties report experiencing SH in the workplace within the preceding 2 yr; 10% of female otolaryngologists report significant SH within this period of time; in all instances, SH needs to be reported, through any kind of media; every HC organization needs a clear, comprehensive policy

Earning disparity: as per the US Bureau of Labor Statistics, median weekly earnings were $1089 for men and $900 for women in the first quarter of 2021; the gap is even greater for women of color and increases with the increasing level of seniority of women in their field; in the annual Medscape Physician Compensation Report (2020), 25% of responders were <40 yr; most frequently reported debts were housing, car, medical, college, and educational loans; salary reduction during the COVID-19 pandemic was reported, and many women reported working ≈3 hr/wk less than men

Disparities in income: in 2020, the median income for female primary care physicians (PCPs) was 80% that of male PCPs ($212,000 vs $264,000); female specialists earned 76% that of the average man in the same specialty ($375,000 vs $286,000); data from 135,000 licensed US physicians over a 6-yr period suggest that, in 2019, female medical doctors (MDs) were making 25% less than male MDs, and, in 2020, female MDs were making 28% less than male MDs; the average male physician currently earns $116,000 more annually than a female physician; disparity in income between men and women can have huge impact on paying off loans; survey of female faculty in 24 US public medical schools — showed that the average salary disparity was 8% less than men, even after considering age, experience, faculty rank, research productivity, and clinical revenue; otolaryngology specialty has the highest reported gap in earnings between men and women; average male otolaryngologists earn $493,000 per year, whereas women earn $384,000 reasons commonly given for income discrepancy include women not asking for as much money as men, women working fewer hours than men, and women wanting time off for maternity leave and childcare; however, multiple studies have shown that women ask for raises and promotions at the same rate as men; implicit gender bias has been prevalent in medicine for many years

Career opportunities for men vs women: women are much more likely than men to pursue a career in academic medicine, yet women hold only 16% of full dean-of-department chairs and only 27% of full professorship, and do not receive independent grants, publications, or leadership positions at the same rate as men; these disparities are even worse in physicians of color; among medical faculty, ≈59% are men and ≈64% are White individuals; women should ask for equal pay, inquire about “perks” (eg, maternity leave, moving expenses, affordable housing), and research financial data before pay negotiation through surveys; female PCPs work 9% fewer hours per week than men and spend 16% more time with the patient, leading to 11% fewer office visits and 11% less revenue from office visits; however, this still does not explain income disparity of 20% to 28%; one survey showed that 23% of female MDs (vs 4% of male MDs) were not working full-time postresidency, mainly because of family; focusing on improved outcomes and preventive care is essential in addressing high HC cost

Health statistics: female MDs have lower hospital mortality and admission rates, better patient outcomes, and less treatment complications; female cardiologists have better outcomes than men; female MDs are more likely to follow clinical guidelines

Work-life balance: women experience more burnout than male MDs; otolaryngology residents are in one of the highest groups with resident burnout; biggest factors include electronic medical records, family concerns, and work hours; female otolaryngologists often feel a lack of support from male peers

Readings

Bickel J. Women in academic medicine. J Am Med Women’s Assoc. 2000;55(1):10-12, 19; Fleteher MM. A preliminary report on the woman otolaryngologist. Am J Otolaryngol. 1980; I :211- 12; Lawlor C, Kawai K, Tracy L, et al. Women in otolaryngology: Experiences of being female in the specialty. Laryngoscope. 2021;131(2):E380-E387. doi:10.1002/lary.28917; Lindsay R. Gender-based pay discrimination in otolaryngology. Laryngoscope. 2021;131(5):989-995. doi:10.1002/lary.29103; Miller AL, Rathi VK, Burks CA, et al. Assessment of gender differences in clinical productivity and Medicare payments among otolaryngologists in 2017. JAMA Otolaryngol Head Neck Surg. 2020;146(9):822–830. doi:10.1001/jamaoto.2020.1928; Ness RB, Ukoli F, Hunt S, et al. Salary equity among male and female internists in Pennsylvania. Ann Intern Med. 2000;133 (2): 104-10.

Disclosures

For this program, members of the planning committee reported nothing relevant to disclose.

Acknowledgements

Dr. Derebery was recorded at the 46th UIC Midwinter Symposium on Practical Challenges in Otolaryngology, held February 28 to March 4, 2022, and presented by University of Illinois College of Medicine at Chicago. For information on future CME activities from this presenter, please visit https://cemedicine.uic.edu/. Audio Digest thanks the speakers and University of Illinois College of Medicine at Chicago for their cooperation in the production of this program.

CME/CE INFO

Accreditation:

The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Audio Digest Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation. Audio Digest Foundation designates this activity for 0 CE contact hours.

Lecture ID:

OT551103

Expiration:

This CME course qualifies for AMA PRA Category 1 Credits™ for 3 years from the date of publication.

Instructions:

To earn CME/CE credit for this course, you must complete all the following components in the order recommended: (1) Review introductory course content, including Educational Objectives and Faculty/Planner Disclosures; (2) Listen to the audio program and review accompanying learning materials; (3) Complete posttest (only after completing Step 2) and earn a passing score of at least 80%. Taking the course Pretest and completing the Evaluation Survey are strongly recommended (but not mandatory) components of completing this CME/CE course.

Estimated time to complete this CME/CE course:

Approximately 2x the length of the recorded lecture to account for time spent studying accompanying learning materials and completing tests.

More Details - Certification & Accreditation